Under the guidance of Mary A. Young, M.D., and Georgetown University Medical Center (GU) the following organizations propose to join GU in becoming a CDC-NIAID WIHS study site: Howard University Medical Center, Whitman-Walker Clinic, Montgomery County Health Department and Inova Health System of Northern Virginia. The DC Metropolitan Consortium sites will enroll 360 HIV infected women and 90 high-risk HIV negative women during the first eighteen months of the study. We plan to retain 82% of our total study population over time, with 368 women completing the study in Year 4. The DC Metropolitan WIHS Consortium is committed to the full participation of the ethnic minorities, substance abusers and the socioeconomically disadvantaged women that are most burdened by the AIDS epidemic. Our consortium sites were selected because they provide ongoing care to large numbers of HIV-infected and high-risk women; currently we treat 658 HIV-infected women of whom over 80% are African- American, 16% White, and 4% Hispanic. The racial and ethnic make-up of the patients we treat is almost identical to that of the HIV infected female population in the Washington Metropolitan Area as a whole. the route of transmission for our patients also reflects those of the general population, with almost 80% of our women infected through IVDU and contaminated needles, or sex with an infected person, usually an IVDU himself. A Whitman-Walker satellite clinic in Ward 8 of Washington, D.C. will expand our access to IVDUs and chronically underserved D.C. residents. In addition, wide community support has been enlisted to assure referrals and the broadest representation possible. We propose to study the clinical, immunologic, virologic and behavioral aspects of HIV disease progression in women, and the rate of and factors affecting HIV seroconversion in a smaller cohort of HIV negative controls. Women-specific research into HIV is increasingly important because the number of AIDS cases and the incidence of HIV infection in women is expanding rapidly. The establishment of a CDC-NIAID WIHS study consortium will allow us to contribute to this valuable research. The WIHS study will also increase access to gynecological care for women, and serve to consolidate the network of services available to HIV infected women in our community.